Skeletal Muscle and Peripheral Nerve Pathology I

Question 1

looking for what in CSF

Answer 1

protein

inflammation

Question 2

types of peripheral nerve injury

Answer 2

1 - axonal - trauma
2 - demyelinating - MS/GB
3 - neuronopathies - kill nerve body - polio

Question 3

MBP

Answer 3

myelin basic protein
-role in myelin compaction

mutant forms - charcot marie tooth disease

demyelinating neuropathy - slow conduction

Question 4

atrophy of leg muscle

Answer 4

polio

Question 5

acute axonal injury

Answer 5

degeneration of distal axon

Question 6

reinnervation of myofibers

Answer 6

myelinated by proliferating schwann cells

new internodes shorter and myelin sheath thinner

Question 7

axonal degeration

Answer 7

loosened myelin layers

lipid droplet vaculoles

Question 8

what does nerve follow to regenerate

Answer 8

myelin

Question 9

mononeuropathy

Answer 9

affect single nerve

trauma, entrapment, infection

Question 10

polyneuropathy

Answer 10

affect multiple nerves

symmetric fashion

stocking and glove distribution

Question 11

mononeuritis multiplex

Answer 11

disease process damaging several nerves in haphazard fashion

vasculitis common cause

Question 12

polyradiculoneuropathy

Answer 12

affect nerve root as well as peripheral nerve

-diffuse symmetric sx prox and distal parts of body

Question 13

acute inflammatory demyelinating polyneuropathy

Answer 13

guillan barre

Question 14

paralysis and areflexia, DTR gone, nerve conduction slow, CSF protein high, preceding acute flu-like illness

Answer 14

guillan barre

Question 15

guillan barre infections

Answer 15

campylobacter jejuni
CMV
EBV
mycoplasma pneumonia
prior vaccination - no evidence

Question 16

nerve biopsy

Answer 16

often lymphocytes

Question 17

chronic guillan barre

Answer 17

2 months or more

doesn’t get better

Question 18

onion bulb neuropathy

Answer 18

demyelinzation

Question 19

myelin basic protein

Answer 19

stain for myelin

Question 20

ulnar deviation

Answer 20

rheumatoid arthritis

Question 21

systemic autoimmune diseases with neuropathy

Answer 21

rheumatoid arthritis
sjogren
SLE

Question 22

vasculitis

Answer 22

non-infectious inflammation of blood vessels - can involve and damage peripheral nerves

Question 23

fibrinoid necrosis of vessels

Answer 23

polyarteritis nodosum

Question 24

target lesion

Answer 24

lyme

Question 25

pseudomembrane

Answer 25

diptheria toxin causes neuropathy

Question 26

most common cause of stocking glove peripheral neuropathy

Answer 26

diabetes

Question 27

thin myelinated nerve, thick endometrial vessel, nodular sclerosis of glomerulus

Answer 27

diabetes

Question 28

numbness, loss of pain sensation, difficulty with balance, paresthesia, dysthesia

Answer 28

distal symmetric diabetic polyneuropathy leads to foot and ankle fractures, chronic skin ulcers also - diabetics have autonomic dysfunction postural hypotension, incomplete bladder emptying, sexual dysfunction

Question 29

peripheral neuropathy in diabetic

Answer 29

has variable presentation

Question 30

distal, symmetric neuropathy, asymptomatic or muscle cramp, distal dysesthesias, diminished DTRs

Answer 30

uremic neuropathy -with chronic renal failure axonal degeneration is primary event** recovery after dialysis

Question 31

compression mononeuropathy with distal symmetric sensory polyneuropathy

Answer 31

thyroid dysfunction - hypothyroid

Question 32

vit B12 deficiency

Answer 32

pernicious anemia | -subacute combined degeneration with damage to long tracts in SC and peripheral nerves

Question 33

peripheral neuropathy deficiency

Answer 33

``` B1 (thiamine) B6 (pyridoxine) folate vit E copper zinc ```

Question 34

uremic frost

Answer 34

white froth around mouth with neuropathies

Question 35

wernickes encephalopathy

Answer 35

image of brain lesion | -from thiamine deficiency**

Question 36

toxic neuropathies

Answer 36

alcohol heavy metals - lead, mercury, arsenic, thallium medications - vinca alkaloids, taxanes, cisplatin

Question 37

basophilic stippling on RBC

Answer 37

lead poisoning can cause neuropathy

Question 38

dots on hands with neuropathy

Answer 38

arsenic

Question 39

direct infiltration of tumor to brachial plexus

Answer 39

pancoast tumor

Question 40

paraneoplastic sensorimotor neuropathy

Answer 40

with small cell lung cancer

Question 41

waldenstroms

Answer 41

B cell IgM immunoglobulins | -hyperviscosity an demyelinating peripheral neuropathy

Question 42

periphera nerve injury/entrapment

Answer 42

carpal tunnel

Question 43

2nd and 3rd toes neuropathy with trauma | -dancer

Answer 43

whartons neuroma

Question 44

charcot marie tooth disease

Answer 44

sensory AND motor neuropathy inherited genetic disorder**

Question 45

distal muscle atrophy, sensory loss, foot deformity

Answer 45

CMT - charcot marie tooth disease see bruising, cuts, abrasions - no symptoms - no sensation of pain**

Question 46

pes cavus foot

Answer 46

with CMT 1 high arch and prominent metatarsal heads

Question 47

painless weakness

Answer 47

with disorders of NMJ

Question 48

myasthenia gravis

Answer 48

painless weakness** autoimmune - Abs against AChR

Question 49

associations with myasthenia gravis

Answer 49

thymoma / thymic hyperplasia | anti-AChR Abs

Question 50

weakness that worsens with exertion

Answer 50

myasthenia gravis | also see diplopia and ptosis

Question 51

tx of myasthenia gravis

Answer 51

acetylcholinesterase inhibitors

Question 52

lambert eaton myasthenic syndrome

Answer 52

autoimmune disorder causing Abs that block ACh release by inhibiting presynaptic Ca channel gets better with exertion**

Question 53

myasthenia gravis vs. lambert eaton

Answer 53

MG - postsynaptic LE - presynaptic LE - better with exertion MG - worse with exertion

Question 54

association with lambert eaton

Answer 54

neuroendocrine carcinoma of lung | -small cell

Question 55

CD8 T cells

Answer 55

polymyositis

Question 56

CD4 T cells

Answer 56

dermatomyositis